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Healthstyles: Medicare and Desegregation

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This week’s Healthstyles program features two interviews by Helina Selimon, Graduate student in the School of Journalism, City University of New York and summer intern at the Center for Health, Media & Policy at Hunter College. The interviews focus on the 50th anniversary of Medicare, landmark legislation that desegregated hospitals when it was implemented in 1966. Selimon talks with David Barton Smith, PhD, Professor Emeritus at Temple University and author of the book, Health Care Divided; and CUNY Associate Professor of Public Health Barbara Berney, PhD, who is producing a film on the this historical aspect of Medicare. Healthstyles producer Diana Mason talks with Selimon about her interest in this topic and its importance to everyone.

Dr. Mason also airs part of an interview with integrative healthcare expert Mary Jo Kreitzer, PhD, RN, FAAN, and co-editor of the Global Advances in Health and Medicine, a journal that focuses on whole-person and whole-system health and well-being, as well as complementary and integrative therapies. The journal will be offered as a premium for listeners who make a donation to the station, WBAI, 99.5 FM in New York City, or streaming at www.wbai.org, between 1:00 and 2:00 on Thursday, July 30, 2015. Donations can be made during that time by calling 212-209-2950, or go online at http://www.give2wbai.org/category_s/1830.htm. Please earmark your donation to Healthstyles.

Healthstyles is sponsored by the Center for Health, Media & Policy at Hunter College, City University of New York.

 

How Medicare Changed Civil Rights in America

by Helina Selemon

 

Kozzi-clipboard-624x832In 1954, Brown v. Board of Education showed America that schools separated by race enabled institutional inequality, forcing the integration of schools. In 1965, Medicare showed America the same thing but in the nation’s hospitals.

Medicare, the federal health insurance program for seniors and disabled individuals, celebrates its 50th anniversary on July 30. It also marks nearly half a century of desegregated hospitals in America. The program, created in the midst of President Johnson’s “Great Society” campaign, transcended its purpose of widening insurance access to these populations; this program was a radical shift in healthcare delivery to minorities.

“It flew in the face of 50 years of history of the federal government had provided for this construction of segregated hospitals,” said David Barton Smith, Emeritus Professor of Health Services at Temple University.

The professor and author of Health Care Divided: Race and Healing a Nation said by enforcing desegregation, Medicare began to meaningfully address the gross racial disparities racism caused in health care.

Before 1965, healthcare was drastically different for Black people all over the U.S., especially in the South.

“Healthcare in the south and the north was segregated and access for blacks was quite limited. In many communities, blacks had no hospitals to go to,” Smith said. “They were excluded all together.”

The federal Social Security law as it stood prior to the Medicare amendment could not enforce racial equality. Title VI in the law stated that hospitals could not discriminate while simultaneously taking federal funds, but it had no way to ensure that was happening.

“It wasn’t enough because Title VI had no enforcement mechanism, no staff made available to enforce that requirement,” Smith said. “ It relied on a complaint process and complaint process are very difficult to use.”

Smith said the advocacy role that Black doctors and nurses took to change the legislation was key to the creation of Medicare. They collected complaints and lobbied in local NAACP offices push for an enforceable law.

“If it hadn’t been for the black medical activists, there probably wouldn’t have been a Civil Rights Movement at all. They were the ones in the Black communities in the South that were insulated enough from retaliation from the white power structure that they could act as advocates for the patients they served,” Smith said.

After Medicare was passed in 1965, the federal government had one year to guarantee equal access to care and facilities across the country. This meant inspecting every hospital and health care facility in the country.

Nine months later, there was still no plan from the government on how to accomplish this task. By the middle of 1966, John Gardner, then Secretary of Health, Education and Welfare, decided his administration would have to recruit government employees to do the job.

Garner was initially worried about interest, but 700 employees, many of whom were civil rights activists themselves, agreed to volunteer. They were trained for two days before fanning across the country to inspect about 3,000 hospitals in less than three months.

Segregated hospitals and states were faced with two choices: to stay segregated and receive no Medicare money, or to take the Medicare money and integrate. In some facilities, Medicare funding could total up to a quarter of a hospital’s budget.

The financial repercussions made the social policy work. “Nobody talks about it but there’s a Golden Rule in health care: the ones that have the gold, rule,” Smith said.

Many stories of these inspectors and the desegregation process are being collected for a documentary set to come out in 2016, when Medicare celebrates 50 years since its implementation. Barbara Berney, Director of the Health Policy and Management Program at Hunter College, a program at the CUNY School of Public Health, is producing this film.

Tune in to HealthStyles on WBAI, 99.5 FM, NY on July 30th, at 1pm Eastern to hear more from Helina on Medicare’s role in the Civil Rights movement.

 

Helina Selemon is a student at the CUNY Graduate School of Journalism in New York City. She is interning this summer with the Center for Health, Media & Policy.

Healthstyles, July 16: Ethics in Nursing and Health Care

ethics moral philosophy word cloud concept on white

Nurses are confronted every day with ethical dilemmas when they bear witness to health care practices that endanger the lives of people. They often have to choose between being silent and experiencing the moral distress of knowing you’re not living up to your professional responsibilities or being an outspoken advocate for ethical practice and risking losing your job or being undermined at work.

Today, Healthstyles focuses on ethics in nursing and health care.  Producer Diana Mason interviews Marcia Bosek, DNSc, RN, Associate Professor of Nursing at the University of Vermont, about the code of ethics that the nursing profession has adopted as a contract with the public to protect and preserve their wellbeing and ethical practice. The code has been revised by the American Nurses Association and can be a tool for nurses and patients to hold people accountable for ethical practice. You can listen to the interview here:

But first, she talks with Nicki Gjere, MS, RN, a nurse who decided that she had to speak up about what appears to be repeated violation of ethical standards in health care research at the University of Minnesota Medical Center. A patient with a mental disorder was recruited into a clinical trial for an experimental drug and later killed himself. His mother and others argued that the researchers coerced the patient into the study and didn’t heed signs that he was deteriorating. When the researchers, University and medical center denied wrongdoing, Gjere spoke out. You can listen to the interview here:

So tune in at 1:00 on Thursday, July 16, 2015, to Healthstyles on WBAI, 99.5 FM in NYC or streaming at www.wbai.org.

Healthstyles is sponsored by the Center for Health, Media & Policy at Hunter College, City University of New York.

 

Media Fellowship on Healthcare Workforce – Call for Applicants!

 

Deadline: August 14, 2015, 5pm ET

download guidelines here

typewriterThe Center for Health, Media & Policy at Hunter College, City University of New York, has launched a new Healthcare Workforce Media Fellowship to train a recent graduate or early-career journalist on key aspects of reporting on healthcare and nursing workforce issues. The Fellowship is supported by a grant from Johnson & Johnson.

The goal is to improve journalists’ coverage of healthcare workforce issues, with particular attention to the factors that affect existing and new roles of nurses and other health care providers as the nation focuses on improving people’s experiences with care, improving health, and reducing health care costs.

The Fellow will investigate and report on a relevant topic of his or her choice for eight months, including cross-platform reporting.

The Fellow will be selected from a pool of post-graduate and early career health journalist applicants in August and will begin work with CHMP on September 15, 2015.

The Fellow will receive a stipend and support to attend a major healthcare or health journalism conference to foster networking and conversations with other journalists about nursing and workforce issues. The fellow will also have opportunities for one-on-one learning, training, and networking with experts in nursing, policy and journalism from CHMP’s national advisory council.

Who Can Apply?

Interested applicants should:

  • Be a recent graduate (<2 years)of a recognized graduate journalism school and/or
  • have worked as a journalist for no longer than five (5) years.
  • Have strong interest in and commitment to health journalism, multimedia reporting and health care workforce issues
  • Be available to meet in person with the program director and National Advisory Council members in NYC* monthly and be available for regular telephone or Skype check-ins. *Applicants outside of the NYC Metro area will be happily considered if willing/able to travel to NYC at their own expense for monthly meetings.

Commit to publishing, at minimum one multimedia report, of at least 20 minutes (with a video or radio component) one print article or series of at least 1000 words, and two republications on a healthcare workforce issue that includes a nursing dimension; and demonstrate use of nurses as sources on health and health care.

Requirements

All articles must be published, broadcast, or posted through distributed or circulated news media entities rather than personal blogs, and will be required to include a note at the beginning or end crediting that it was written/produced in conjunction with the fellowship (Sample texts will be provided that can be adapted for different media).The stories must reach an audience within the U.S.

Short-term story: The Fellow must produce a story of no less than 1000 words (or comparable broadcast length) stemming directly from any aspect of meetings with one or more members of the National Advisory Council or other available CHMP expert.

The piece must be completed no later than December 24, 2015, and scheduled to be disseminated no later than January 15, 2016. The story can be a news report, feature, or commentary/blog about a meeting, or expand upon a relevant study or discussion of health workforce issues.

Applicants do not need to propose a topic for the short-term story ahead of time, nor do they have to obtain advance approval from an editor/producer that the piece will be considered as an editorial assignment for publication or broadcast. The subject matter does not have to relate to the longer-term project and can be published through a different media organization if desired. However, it is the Fellow’s responsibility to ensure pieces are published according to stated deadlines.

Therefore, applicants should indicate where they expect to place the short-term story if it will appear in a different news outlet than the long-term project.

Long-term project: Each applicant should submit a proposal (of one to two pages) outlining a major story or series that she or he intends to research and write. The story or series should be of the Fellow’s own design, documenting and explaining a pressing issue regarding healthcare workforce issues, with particular attention to the factors that affect existing and new roles of nurses and other health care providers.

The project deadline is Friday, March 4, 2016, and it must be scheduled to be disseminated no later than Saturday, April 30, 2016. The story or series need not be based on any specific meeting with the National Advisory Council or health conference, although the fellow is welcome to interview any NAC member or conference expert(s) as part of the piece.

Along with the application, candidates must include an agreement by his or her editor/producer to accept the long-term project proposal as an editorial assignment for publication or broadcast.

Although the primary editor/producer for stories will be at each reporter’s news outlet, fellows will be encouraged to consult with program director Liz Seegert or CHMP co-directors Diana Mason and Barbara Glickstein for help with sources and background.

Dissemination

The stories resulting from this fellowship will first be published by the journalist’s media organization. HealthCetera, the blog of CHMP, HealthStyles Radio, and New America Media then have the option to cross-post the stories — with full credit and links back to the primary publisher — and make them available to member Pacifica stations or, in the case of NAM, its network of ethnic media outlets. Stories or broadcast reports must include appropriate supporting text (to be supplied) to the Fellowship, CHMP, and Johnson & Johnson.

It may be necessary to work with CHMP and NAM editors to adapt reports to their specific format(s). This may result in shorter article(s) or multimedia reports for distribution. The Fellow will have the right of final approval on any such editing prior to publication or air.

Stipend and Travel

The fellow will receive a stipend of $1,500, with half to be paid on start of the fellowship and the remainder upon completion of the long-term project. CHMP will reimburse the Fellow up to $1,000 for travel, meals and expenses to attend one national journalism or healthcare conference or two regional conferences.

Selection Process and Eligibility

The fellowship selection panel will include journalism, nursing, and policy experts from the Center for Health, Media & Policy. Since this is the inaugural year of the Media Fellowship, the application process is open to any post-graduate or early-career journalist (<5 years’ experience).

Additional Information

For further details about fellowship requirements and potential stories, contact Liz Seegert, Program Director, Center for Health, Media & Policy at mediafellow@healthmediapolicy.com. Be sure to reference application questions in the subject line.

Application Process

Applications must be submitted in a single Microsoft Word or Adobe PDF file consisting of the following  components:

A cover letter containing:

  • Applicant name
  • Mailing address
  • Office phone
  • Mobile phone
  • E-mail
  • Employer (Freelancers must specify their length of affiliation with the outlet that will publish or broadcast the story.)
  • Employer address
  • Employer phone
  • Employer’s circulation and audience demographic (Please indicate whether this media outlet serves a general audience or a specific community.)
  1. A resume.
  2. A one to two-page proposal or detailed outline describing an idea for long-term project topic, how the subject will be be researched and covered, its relevance to the audience, and why you chose to cover the issue.
  3. A letter from an editor/producer agreeing to accept the long-term project proposal as an editorial assignment for publication or broadcast.
  4. No more than three samples of published or broadcast journalistic work. For applicants submitting print samples, the full story text must be included in the application document. For applicants submitting broadcast samples, please include hyperlinks to these stories — either on a news organization’s website or a file sharing site such as filesanywhere.com — in the application document.

Applications that are not submitted in a single Microsoft Word or Adobe PDF file will not be reviewed. Please submit the file (using a file name format of “LastnameFirstname.doc” or “LastnameFirstname.pdf”) using the following link: http://bit.ly/1KYUTtd

Deadline: August 14, 2015; 5pm ET

Applicants will be notified on or before August 31, and selected candidate must be available for an introductory meeting on Tuesday, September 15, in New York City.

download a copy of these guidelines.

The Un-Boring Medical Conference: How CUNY Nurses Transform Health Care

By Helina Selemon

What happens when nurses, armed with simulation technology and innovative learning pedagogies, get together to share how they’ve transformed nursing education at their schools?

nursingdummy

A mannequin at a simulation technology vendor booth. These high-fidelity simulators have pulses and injection sites, some can perspire and convulse.

You get a modern, savvy and “culturally competent” workforce that tackles the city’s biggest healthcare problems, like health disparities in underserved populations. That’s the goal of the New York City Nursing Education Consortium in Technology (NYCNECT, pronounced, “N-Y-Connect”), a CUNY-wide network of nurse educators.

This consortium, a five-year, grant-funded project by the U.S. Department of Health and Human Services, trains nurse educators hailing from every nursing school in the City University of New York system on how to incorporate simulation technology into their nursing programs. Hunter College School of Nursing has been the flagship institution for this grant-funded project aimed at helping faculty nurse educators integrate technology into nursing education and practice. This year marked five years, and this June’s meeting was their last. Luckily, I had the opportunity to attend.

Now I say “luckily” for a reason. I used to work in cardiovascular research lab at a heart and lung research institute. I attended over a dozen conferences: covering heart and lung research, medical research, and innovations in research tools.

Tim Clapper

Knowing the education basics. Keynote speaker Tim Clapper, PhD, an renowned education and simulation consultant, talks about education philosophy and how to keep their technology practical and not distracting, especially for adult learners. “People want learning to be authentic. They want their learning environment to look like what their work environment looks like, “Clapper said.

Even after leaving science for journalism, I roamed my fair share of science, health education, writing and research meetings and forums, mostly for story research. I have learned that these gatherings, more often than not, look the same and are structured similarly. They all have their buzzy room full of posters, attendees chatting in pairs or trios, vendors scanning the room from their booths armed and ready for promotion, and refreshments sitting temptingly in the far corner of the room.

  • Focusing on the big picture from the very beginning: NYCNECT Project Manager Shawn McGinniss, kicks off the conference with a message about the importance of teaching nurses well. McGinniss, whose background is in instructional design for health profession training, said that the impact he sees since starting with the project over five years ago, “is inspiring because it doesn’t stop with our students. This work—everything we work very hard for—ends up benefitting our student’s patients and their families.” And seeing as CUNY graduates over half of New York City’s working RNs, this impact stands to transform healthcare in the city.
  • Nurses in NYCNECT are always learning. In a room of over 40 nurses, no one seemed dependent on coffee. They’re not just getting introduced, but they’re actively taking lessons throughout the year to become masterful at these methods of instruction.
  • For the first time, the keynote speaker isn’t a nurse. Many conferences feature a person from their field. In past years, NYCNECT had done the same, recruiting influential voices in nursing and nursing education, people like Mary Anne Rizzolo, to speak. This year, it was a simulation consultant, Tim Clapper, who gave an engaging talk about teaching methods in health education and how to use technology to advance and not distract learners. His status as a simulation consultant and not a nurse turned out to not be a distraction, either. “Dr. Clapper’s presentation was engaging, interesting and intuitive, I believe every educator would find something to learn and something to apply to their classroom from this speaker,” said nurse Jennifer Louis, an Assistant Professor of Nursing at LaGuardia Community College.
  • Nurses are a tight community. In a room full of what organizers call “nurse-transformers,” from over a dozen CUNY institutions with first-time attendees and perennial returners, I walked by two nurses making introductions. “I’ve known you by name for a long time!” said one. It made me realize how much a role NYCNECT plays in peer-to-peer networking.
  • Nurses learn more than tech. The conference is about equipping teaching nurses with
    Nurses from York College talk about their collaboration with Shadow Health, a simulation program used to teach their nursing students how to interact with their patients.

    Nurses from York College talk about their collaboration with Shadow Health, a simulation program used to teach their nursing students how to interact with their patients.

    more than how-to’s with medical technology tools, McGinniss explains. Tools, he said, do not work without good instruction. It’s not just teaching with simulation, but to really understand the learning theory and practices behind it that make it useful. Not just tech for the sake of tech. You’re always going to have options for new tools, so if you maintain a solid understanding of pedagogy at play then the tools are just that, tools.”

  • The program prides itself on providing CUNY faculty with hands-on instruction in innovative pedagogy and how to integrate healthcare simulation, informatics, and telehealth. But it does more than that. At the end of the day, one nurse got up and thanked the organizers for introducing her to the iPad. Another nurse credited the consortium for influencing her to get “smart” and use a smartphone.
  • They want to continue learning and sharing. I expected some cynicism or dismay over lack of funding for future collaboration, but these nurses were intent on keeping the momentum going. A panel of nurses opened up this discussion and most agreed that an annual conference is a must. “We’re talking about a way to form a core group of representatives that would represent all the schools and campuses and identify ongoing needs,” McGinniss said. “It’s all very exploratory.”

This consortium was funded by the Health Resources and Services Administration (HRSA) for the Faculty Development: Integrated Technology into Nursing Education and Practice Initiative (Faculty Development: ITNEP).

Helina Selemon is a student at the CUNY Graduate School of Journalism in New York City. She is interning this summer with the Center for Health, Media & Policy.

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